A Software Shrink: Apps and Wearables Could Usher In an Era of Digital Psychiatry

Zach has been having trouble at work, and when he comes home he’s exhausted, yet he struggles to sleep. Everything seems difficult, even walking—he feels like he’s made of lead. He knows something is wrong and probably should call the doctor, but that just seems like too much trouble. Maybe next week.

Meanwhile, software on his phone has detected changes in Zach, including subtle differences in the language he uses, decreased activity levels, worsening sleep, and cutbacks in social activities. Unlike Zach, the software acts quickly, pushing him to answer a customized set of questions. Since he doesn’t have to get out of bed to do so, he doesn’t mind.

Zach’s symptoms and responses suggest that he may be clinically depressed. The app offers to set up a video call with a psychiatrist, who confirms the diagnosis. Based on her expertise, Zach’s answers to the survey questions, and sensor data that suggests an unusual type of depression, the psychiatrist devises a treatment plan that includes medication, video therapy sessions, exercise, and regular check-ins with her. The app continues to monitor Zach’s behavior and helps keep his treatment on track by guiding him through exercise routines, noting whether or not he’s taking his medication, and reminding him about upcoming appointments.

While Zach isn’t a real person, everything mentioned in this scenario is feasible today and will likely become increasingly routine around the world in only a few years’ time. My prediction may come as a surprise to many in the health-care profession, for over the years there have been claims that mental health patients wouldn’t want to use technology to treat their conditions, unlike, say, those with asthma or heart disease. Some have also insisted that to be effective, all assessment and treatment must be done face to face, and that technology might frighten patients or worsen their paranoia.

However, recent research results from a number of prestigious institutions, including Harvard, the National Alliance on Mental Illness, King’s College London, and the Black Dog Institute, in Australia, refute these claims. Studies show that psychiatric patients, even those with severe illnesses like schizophrenia, can successfully manage their conditions with smartphones, computers, and wearable sensors. And these tools are just the beginning. Within a few years, a new generation of technologies promises to…

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